A child has been hospitalized with a sickle cell crisis and given morphine sulfate (Duramorph) for severe pain. On assessment 45 minutes later, the child appears to be sleeping quietly with a respiratory rate of 6 breaths/minute
What action by the nurse is most appropriate?
A.
Document findings and let the child sleep.
B.
Plan to hold the next dose of morphine.
C.
Prepare to administer naloxone (Narcan).
D.
Wake the child up to take deep breaths.
ANS: C
This child's respiratory rate is dangerously low, brought on by the narcotic analgesic. The nurse should prepare to administer Narcan per protocol. Letting the child sleep could lead to respiratory arrest, although the findings and subsequent actions should be documented. The provider should be notified afterward to adjust the next dose of pain medication. The child may or may not be able to cooperate with deep breathing instructions.
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